Provider Demographics
NPI:1376986570
Name:PONTIUS, KAREN KAY (RPH)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:KAY
Last Name:PONTIUS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:ARKANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67005-3814
Mailing Address - Country:US
Mailing Address - Phone:620-442-7256
Mailing Address - Fax:
Practice Address - Street 1:201 S SUMMIT ST
Practice Address - Street 2:
Practice Address - City:ARKANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:67005-2846
Practice Address - Country:US
Practice Address - Phone:620-442-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-08
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-10485183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist